Choosing Wisely interventions to reduce antibiotic overuse in the safety net.

Objectives: Physician pay-for-performance (P4P) programs frequently target inappropriate antibiotics. Yet little is known about P4P programs' effects on antibiotic prescribing among safety-net populations at risk for unintended harms from reducing care. We evaluated effects of P4P-motivated interventions to reduce antibiotic prescriptions for safety-net patients with acute respiratory tract infections (ARTIs).

Evaluation of Recruitment of Older Adults of Color into a Community-Based Chronic Disease Self-Management Wellness Pathway Program in Los Angeles County.

Background: Established relationships between researchers, stakeholders and potential participants are integral for recruitment of potential older adult participants and Evidence-Based Programs (EBPs) for chronic disease management have empirically been shown to help improve health and maintain healthy and active lives. To accelerate recruitment in EBPs and potential future research, we propose a Wellness Pathway allowing for delivery within multipurpose senior centers (MPCs) linked with medical facilities among lower-income urban older adults. The study aims were to: 1) assess the effectiveness of three MPC-delivered EBPs on disease management skills, health outcomes, and self-efficacy; and 2) assess the feasibility of the proposed Wellness Pathway for lower-income urban-dwelling older adults of color.

Mistrust of Researchers Correlates with Stroke Knowledge among Minority Seniors in a Community Intervention Trial.

Background: Medical mistrust influences patients' treatment seeking, adherence, health behaviors, and minority participation in research studies. However, medical mistrust remains understudied within neurological diseases like stroke despite disproportionately affecting minority populations.

Objective: This study examines the relationship of medical mistrust with stroke knowledge among Black, Latino, Korean, and Chinese-Americans.

Community-Partnered Evaluation of the Aging Mastery Program in Los Angeles Area Senior Centers.

The National Council on Aging's Aging Mastery Program (AMP) aims to help older adults implement health behavior and lifestyle changes to promote healthy aging and social engagement. The purpose of the present community-partnered evaluation was to test the effectiveness of AMP implementation in Los Angeles County to improve participants' quality of life, global physical and mental health, and patient activation. A modified randomized wait-list controlled trial design was used to examine experimental, quasi-experimental, and dose-response evidence in five senior centers.

Evaluation of an Intervention to Reduce Low-Value Preoperative Care for Patients Undergoing Cataract Surgery at a Safety-Net Health System.

Importance: Preoperative testing for cataract surgery epitomizes low-value care and still occurs frequently, even at one of the nation's largest safety-net health systems.

Objective: To evaluate a multipronged intervention to reduce low-value preoperative care for patients undergoing cataract surgery and analyze costs from various fiscal perspectives.

Design, Setting, And Participants: This study took place at 2 academic safety-net medical centers, Los Angeles County and University of Southern California (LAC-USC) (intervention, n = 469) and Harbor-UCLA (University of California, Los Angeles) (control, n = 585), from April 13, 2015, through April 12, 2016, with 12 additional months (April 13, 2016, through April 13, 2017) to assess sustainability (intervention, n = 1002; control, n = 511).

"Worth the Walk": Culturally Tailored Stroke Risk Factor Reduction Intervention in Community Senior Centers.

Background Racial/ethnic minority older adults have worse stroke burden than non-Hispanic white and younger counterparts. Our academic-community partner team tested a culturally tailored 1-month (8-session) intervention to increase walking and stroke knowledge among Latino, Korean, Chinese, and black seniors. Methods and Results We conducted a randomized wait-list controlled trial of 233 adults aged 60 years and older, with a history of hypertension, recruited from senior centers.

Sugar-dependent rats show enhanced intake of unsweetened ethanol.

Rats show signs of dependence on sugar when it is available intermittently, including bingeing, withdrawal, and cross-sensitization with amphetamine. In the current study, we sought to determine whether sugar-dependent rats would show increased intake of unsweetened ethanol and, conversely, whether intermittent access to ethanol would augment sugar consumption. In Experiment 1, with intermittent versus ad libitum access to ethanol, Sprague-Dawley rats were given escalating concentrations of ethanol (1%, 2%, 4%, 7%, and 9%) over the course of 20 days.

A high-fat meal or injection of lipids stimulates ethanol intake.

Findings of earlier studies support the idea of a possible relation between dietary fat and ethanol intake, but it is unclear whether acute exposure to fat can increase ethanol consumption directly. In the current series of experiments, we examined whether daily overeating of fat, a single high-fat meal, or the injection of fat can increase ethanol intake. In Experiment 1, adult Sprague-Dawley rats were maintained on a high-fat diet (50% fat) for 7 days and switched subsequently to a laboratory chow diet while being trained to drink 9% ethanol.